Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis

Background. The most common indication for cholecystectomy in children is cholelithiasis, and routine histopathological examination is performed on all gallbladder specimens. Currently, selective histopathological examination is suggested instead of routine examination due to the low frequency of g...

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Main Authors: Aysel Ünlüsoy Aksu, Nebiyye Genel, Gülseren Şahin, Ferda Özbay Hoşnut, Ayşegül Tok, Ayşe Karaman
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2024-10-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/4921
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author Aysel Ünlüsoy Aksu
Nebiyye Genel
Gülseren Şahin
Ferda Özbay Hoşnut
Ayşegül Tok
Ayşe Karaman
author_facet Aysel Ünlüsoy Aksu
Nebiyye Genel
Gülseren Şahin
Ferda Özbay Hoşnut
Ayşegül Tok
Ayşe Karaman
author_sort Aysel Ünlüsoy Aksu
collection DOAJ
description Background. The most common indication for cholecystectomy in children is cholelithiasis, and routine histopathological examination is performed on all gallbladder specimens. Currently, selective histopathological examination is suggested instead of routine examination due to the low frequency of gallbladder cancer in adults. The purpose of this study was to evaluate the indications, clinical, laboratory and histopathological findings of the cholecystectomy in children. We also questioned the contribution and cost-effectiveness of routine histopathological evaluation in diagnosis and treatment. Methods. A total of 114 children underwent cholecystectomy between the years 2008 and 2022. The clinical findings, laboratory, and imaging results of the patients and histopathological findings of the gallbladder specimens were evaluated retrospectively. Results. Cholelithiasis were diagnosed in 71%, choledochal malformation in 15.8%, hydrops of gallbladder and/or biliary sludge in 12.3%, and hypoplasia of gallbladder in 0.9% of the patients. Histopathologically significant findings were observed in only 3 patients (2.6%); adenomyomatosis in 2 and angiodysplasia and pyloric metaplasia in 1. While the cost of a cholecystectomy and histopathologic examination combined amounted to 27.77% of the minimum wage in Türkiye in 2024, the histopathologic examination alone constitutes just 0.67% of the minimum wage and 2.4% of the operation fee. Conclusion. In children undergoing cholecystectomy, histopathological examination does not provide any significant contribution to the patient’s diagnosis and follow-up management. In children, selective gallbladder histopathological examination might reduce health costs and save time for pathologists.
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publishDate 2024-10-01
publisher Hacettepe University Institute of Child Health
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spelling doaj-art-5b489d9bccb24387aaf82b89837cc2ff2025-08-20T02:55:20ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212024-10-0166410.24953/turkjpediatr.2024.4921Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysisAysel Ünlüsoy Aksu0https://orcid.org/0000-0002-4550-0717Nebiyye Genel1https://orcid.org/0009-0002-7739-3511Gülseren Şahin2https://orcid.org/0000-0001-6146-3509Ferda Özbay Hoşnut3https://orcid.org/0000-0002-4549-7474Ayşegül Tok4https://orcid.org/0000-0002-7095-8121Ayşe Karaman5https://orcid.org/0000-0001-6860-1222Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, TürkiyeDepartment of Pathology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, TürkiyeDepartment of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, TürkiyeDepartment of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, TürkiyeDepartment of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, TürkiyeDepartment of Pediatric Surgery, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Türkiye Background. The most common indication for cholecystectomy in children is cholelithiasis, and routine histopathological examination is performed on all gallbladder specimens. Currently, selective histopathological examination is suggested instead of routine examination due to the low frequency of gallbladder cancer in adults. The purpose of this study was to evaluate the indications, clinical, laboratory and histopathological findings of the cholecystectomy in children. We also questioned the contribution and cost-effectiveness of routine histopathological evaluation in diagnosis and treatment. Methods. A total of 114 children underwent cholecystectomy between the years 2008 and 2022. The clinical findings, laboratory, and imaging results of the patients and histopathological findings of the gallbladder specimens were evaluated retrospectively. Results. Cholelithiasis were diagnosed in 71%, choledochal malformation in 15.8%, hydrops of gallbladder and/or biliary sludge in 12.3%, and hypoplasia of gallbladder in 0.9% of the patients. Histopathologically significant findings were observed in only 3 patients (2.6%); adenomyomatosis in 2 and angiodysplasia and pyloric metaplasia in 1. While the cost of a cholecystectomy and histopathologic examination combined amounted to 27.77% of the minimum wage in Türkiye in 2024, the histopathologic examination alone constitutes just 0.67% of the minimum wage and 2.4% of the operation fee. Conclusion. In children undergoing cholecystectomy, histopathological examination does not provide any significant contribution to the patient’s diagnosis and follow-up management. In children, selective gallbladder histopathological examination might reduce health costs and save time for pathologists. https://turkjpediatr.org/article/view/4921cholecystectomyhistopathologycholelithiasisadenomyomatosischildren
spellingShingle Aysel Ünlüsoy Aksu
Nebiyye Genel
Gülseren Şahin
Ferda Özbay Hoşnut
Ayşegül Tok
Ayşe Karaman
Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis
The Turkish Journal of Pediatrics
cholecystectomy
histopathology
cholelithiasis
adenomyomatosis
children
title Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis
title_full Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis
title_fullStr Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis
title_full_unstemmed Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis
title_short Cholecystectomy in children: indications, clinical, laboratory and histopathological findings and cost analysis
title_sort cholecystectomy in children indications clinical laboratory and histopathological findings and cost analysis
topic cholecystectomy
histopathology
cholelithiasis
adenomyomatosis
children
url https://turkjpediatr.org/article/view/4921
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AT gulserensahin cholecystectomyinchildrenindicationsclinicallaboratoryandhistopathologicalfindingsandcostanalysis
AT ferdaozbayhosnut cholecystectomyinchildrenindicationsclinicallaboratoryandhistopathologicalfindingsandcostanalysis
AT aysegultok cholecystectomyinchildrenindicationsclinicallaboratoryandhistopathologicalfindingsandcostanalysis
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